多发性骨髓瘤患者血清EPO、IL-6、TNF-α、IL-1β水平及其与贫血的相关性分析

Serum Levels of EPO,IL-6,TNF-αand IL-1βin Patients with Multiple Myeloma and Their Correlation with Anemia

目的探讨不同Durie-Salmon(D-S)分期多发性骨髓瘤(MM)患者血清促红细胞生成素(EPO)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及白介素-1β(IL^(-1)β)水平,并分析其与贫血的相关性。方法选取2018年1月至2019年12月在郑州大学第一附属医院确诊的52例MM患者作为实验组,另选18例健康体检者作为正常对照组,采用酶联免疫吸附法(ELISA)检测各组血清EPO、IL-6、TNF-α及IL^(-1)β水平,用全自动血细胞分析仪检测各组血红蛋白(Hb)水平,并进一步分析血清EPO、IL-6、TNF-α及IL^(-1)β水平与Hb水平的相关性。结果实验组EPO、IL-6、TNF-α及IL^(-1)β水平均高于对照组,差异有统计学意义(P<0.05)。实验组IL-6、TNF-α及IL^(-1)β水平Ⅰ期、Ⅱ期、Ⅲ期呈递增趋势,其中IL-6水平Ⅰ期与Ⅱ期间的差异无统计学意义(P>0.05),Ⅱ期与Ⅲ期间的差异有统计学意义(P<0.05),TNF-α、IL^(-1)βⅠ期与Ⅱ期、Ⅱ期与Ⅲ期间的差异无统计学意义(P>0.05),而Ⅰ期与Ⅲ期间的差异有统计学意义(P<0.05)。实验组EPO水平Ⅱ期分别高于Ⅰ期及Ⅲ期,差异有统计学意义(P<0.05),Ⅲ期高于Ⅰ期,差异无统计学意义(P>0.05);实验组无肾功能损害组EPO水平高于肾功能损害组及对照组,差异有统计学意义(P<0.05),实验组肾功能损害组EPO水平高于对照组,差异无统计学意义(P>0.05)。实验组Hb水平分别与EPO、IL-6、TNF-α及IL^(-1)β水平呈负相关,差异有统计学意义(P<0.05)。结论MM患者血清EPO水平升高但其分泌量仍相对不足,IL-6、TNF-α及IL^(-1)β水平升高,且可能与贫血的加重有关。

Objective To investigate the serum levels of erythropoietin(EPO),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and interleukin-1β(IL^(-1)β)in patients with multiple myeloma(MM)in different Durie-Salmon(D-S)stages,and to analyze their correlation with anemia.Methods All 52 patients with multiple myeloma diagnosed in the First Affiliated Hospital of Zhengzhou University from January 2018 to December 2019 were selected as the experimental group,and 18 healthy subjects in the same period were selected as the normal control group.The levels of serum EPO,IL-6,TNF-αand IL^(-1)βwere detected by enzyme linked immunosorbent assay(ELISA),and the level of hemoglobin(Hb)was detected by automatic hematology analyzer.The correlation between serum EPO,IL-6,TNF-α,IL^(-1)βand Hb content was further analyzed.Results The levels of EPO,IL-6,TNF-αand IL^(-1)βin the experimental group were significantly higher than those in the control group(P<0.05).In the experimental group,the levels of IL-6,TNF-αand IL^(-1)βincreased progressively in stageⅠ,ⅡandⅢ.There was no significant difference in the levels of IL-6 between stageⅠand stageⅡ(P>0.05),but there was significant difference between stageⅡand stageⅢ(P<0.05).There was no significantly difference in TNF-αand IL^(-1)βbetween stageⅠand stageⅡ,stageⅡand stageⅢ(P>0.05).There was significantly difference between stageⅠand stageⅢ(P<0.05).In the experimental group,the level of EPO in stageⅡwas significantly higher than that in stageⅠand stageⅢ(P<0.05),and that in stageⅢwas higher than in stageⅠ,but the difference was not statistically significant(P>0.05).The level of EPO in the experimental group without renal function damage was higher than that in the renal function damage group and the control group,and the difference was statistically significant(P<0.05).The level of EPO in the renal function damage group in the experimental group was higher than that in the control group,but the difference was not statistically significant(P>0.05).The level of Hb in the experimental group was negatively correlated with the levels of EPO,IL-6,TNF-αand IL^(-1)β,respectively(P<0.05).Conclusion The level of serum EPO in patients with multiple myeloma is increased,but its secretion is still relatively insufficient,and the levels of IL-6,TNF-αand IL^(-1)βin patients with multiple myeloma are increased,which may be related to the aggravation of anemia.